Bladder Control Sacral Neuromodulation – The Bionic Bladder

By Maria Canter, MD, MSc

Urogynecology Center of Northern Virginia

. https://www.urogyncenternova.com/

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Bladder Control Sacral Neuromodulation – The Bionic Bladder

For the ladies who have increased urinary urgency, frequency and not enough time to get to the bathroom, this one is for you.

Let's say you go to the doctor and somehow get up the courage to say, “I'm wetting myself.” Now, you are hoping for the magic remedy that will make it all go back to the way it used to be. You've tried playing with your diet. You may have quit your daily coffee or stopped the diet soda. Maybe you have done more Kegel exercises than anyone you know and still no luck. You may even have tried medication. Maybe the medication helped, but you had side effects that were not acceptable. Well, there is still hope.

Sacral Neuromodulation, through the use of the Interstim system, is a proven therapy that targets the communication problem between the brain and the nerves that control the bladder. It is used to treat urge urinary incontinence, overactive bladder symptoms, urinary retention and fecal incontinence.

Interstim is performed in 2 stages, including a test phase.

The first stage can be performed in the operating room or the office. If you do this in the office, you may be instructed to take a pain pill prior to the procedure. The doctor will inject a local anesthetic. Next, a tiny needle is passed through the skin and the S3 foramen of the sacrum on your backside.

A flimsy temporary wire is passed through the inside of the needle and the needle is removed. A transparent dressing is placed over the wire. The wire communicates with an energy source about the size of an iPhone. You can carry it in your purse. When the wire is connected to the stimulator, there is a flutter sensation in the bicycle seat area of your bottom.

While wearing the wire and stimulator for a few days, you will keep a bladder diary. If your diary demonstrates at least 50% improvement in your symptoms, you are a candidate for implant. The wire is removed at the end of the office trial.

The second stage is done in an operating room. The permanent wire and battery are both implanted. The battery is replaced with a quick procedure every 4-6 years. With all of these procedures there is no hospital stay. Success rates are 60 – 80%, depending on the diagnosis being treated.

So, for ladies who have increased urinary urgency and frequency, and haven't found a solution, it may be time to look into the Interstim system.